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feedback.html
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<!DOCTYPE html>
<html lang="en" >
<head>
<meta charset="UTF-8">
<title>Mechanic on the way</title>
<link rel="stylesheet" href="feedback-style.css">
<script>
function done()
{
return true;
}
</script>
</head>
<body>
<!-- partial:index.partial.html -->
<a href="index.html"><img alt="Mech"src="logo-pro.png" width="100px" height="100px" style="float:right; margin-right:10em;"></a>
<form action="submit3.php" method="post" class="my-form">
<div class="container">
<h1>Get in touch!</h1>
<h2>Thanks for reaching out.What's your message about?</h2>
<ul>
<li>
<select>
<option selected disabled>-- Please choose an option --</option>
<option>I'd like to know more about you</option>
<option>I have some feedback</option>
<option>I have to complain about product/service</option>
<option>I'd like to reach out for some another reason</option>
</select>
</li>
<li>
<h2>What would you like to say?</h2>
<li>
<textarea placeholder="Message"></textarea>
</li>
<h2>What's your name?</h2>
<div class="grid grid-2">
<input type="text" placeholder="Name" required>
<input type="text" placeholder="Surname" required>
</div>
</li>
<h2>Enter your email and phone number</h2>
<li>
<div class="grid grid-2">
<input type="email" placeholder="Email" required>
<input type="tel" placeholder="Phone">
</div>
</li>
<h2>Can we get an idea of your problem?</h2>
<li>
<select>
<option selected disabled>-- Please choose an option --</option>
<option>Complaint related to emergency service</option>
<option>Complaint related to general service</option>
<option>Complaint related to automobile product</option>
<option>Complaint related to workforce</option>
</select>
</li>
<li>
<input type="checkbox" id="terms">
<label for="terms">I have read and agreed with <a href="">the terms and conditions.</a></label>
</li>
<li>
<div class="grid grid-3">
<div class="required-msg">REQUIRED FIELDS</div>
<button class="btn-grid" type="submit" disabled>
<span class="back">
<img src="https://s3-us-west-2.amazonaws.com/s.cdpn.io/162656/email-icon.svg" alt="">
</span>
<span class="front">SUBMIT</span>
</button>
<button class="btn-grid" type="reset" disabled>
<span class="back">
<img src="https://s3-us-west-2.amazonaws.com/s.cdpn.io/162656/eraser-icon.svg" alt="">
</span>
<span class="front">RESET</span>
</button>
</div>
</li>
</ul>
</div>
</form>
<footer>
</footer>
<div style="margin: 50px 0; display: flex; align-items: center; justify-content: center; width: 100%; font-size:36px;">
<a style="display: block; text-align: center; color: #555; text-decoration: none; margin-right: 15px; " href="index.html" ><i class="fas fa-home" style="color: #1da1f2; margin-right: 5px;"></i>Get back to our home page</a>
</div>
<!-- partial -->
<script src="feedback-script.js"></script>
</body>
</html>